Bronchiectasis in Pakistan: A retrospective review of patients with non-cystic fibrosis bronchiectasis at a tertiary care center

Abstract

<b>Background:</b> Non-cystic fibrosis (non-CF) bronchiectasis is a major respiratory disease in developing nations. Considering the geographic variation in etiology and clinical features, studies targeting regions where a paucity of data exists are necessary. <b>Objective:</b> To identify the causes, clinical presentation, radiological extent of disease, causative microorganisms and lung functions in patients with non-CF bronchiectasis. <b>Methods:</b> A retrospective study was conducted at the Aga Khan University, Karachi, Pakistan. Adult patients with non-CF bronchiectasis diagnosed on high resolution CT (HRCT) scan between 1990 and 2020, were reviewed for etiology, microbiology, radiology and spirometric pattern. <b>Results:</b> A total of 340 patients (56.5% female) were evaluated. The duration of symptoms in 46.2% of patients was between 1-5 years. Obstructive impairment was the commonest spirometric pattern observed in 58.1% of patients. Previous TB (52.94%) was the commonest etiology followed by allergic bronchopulmonary aspergillosis (7.64%). Bilateral lung involvement was seen in 63.2% of patients on the HRCT scan.&nbsp;<i>Pseudomonas aeruginosa</i>&nbsp;was the commonest identified organism (38.75%) in the 240 patients with available specimens. Patients with<i>&nbsp;P. aeruginosa</i>&nbsp;infections showed a significantly higher number of exacerbations (p=0.016). A significant difference (P&lt;0.001) was seen in&nbsp;<i>P. aeruginosa</i>&nbsp;growth between different etiologies. <b>Conclusion:</b> Considering the growth and high extent of lung involvement with <i>P. aeruginosa</i>, which is associated with poor prognosis, we suggest that in developing countries, regular clinic follow ups should be ensured to improve quality of life&nbsp;and survival.